title: Audit of emergency department assessment and management of patients presenting with community-acquired needle stick injuries.
abstract: OBJECTIVE
  To describe characteristics and management of people with community acquired needle stick injuries (CANSI) attending urban emergency departments; and suggest a guideline to improve assessment, management, and documentation.
  
  
  METHODS
  A retrospective analysis of cases with CANSI attending emergency departments in two tertiary hospitals between 2001 and 2005 using medical record review with follow up phone and written survey.
  
  
  RESULTS
  Thirty-nine cases met the criteria for CANSI. Persons younger than 30 years sustained 48.72% of all injuries. Source serology was available for only five cases (12.82%). Thirty-one of thirty-nine patients (79.49%) were classed as not immune to hepatitis B but only four of these (12.90%) received both hepatitis B vaccination and hepatitis B immunoglobulin. Six patients (15.38%) received HIV prophylaxis; of which two (33.33%) did not receive baseline HIV testing. Of ten patients referred to immunology clinic for follow up only two (20.00%) attended at 6 months.
  
  
  CONCLUSIONS
  We have identified groups that are at high risk of CANSI, including young males, security workers and cleaners. In the majority of cases protection against hepatitis B was inadequately provided, and a substantial proportion had inadequate baseline assessment and documentation. A guideline is suggested that may be used to improve these deficits.
authors.affiliation: University of Western Australia, QEII Medical Centre, Hospital Avenue, Nedlands, WA 6009, Australia. tony.celenza@uwa.edu.au
authors.forename: Antonio
authors.initials: A
authors.lastname: Celenza
authors.forename: Lloyd J
authors.initials: LJ
authors.lastname: D'Orsogna
authors.forename: Shervin H
authors.initials: SH
authors.lastname: Tosif
authors.forename: Samantha M
authors.initials: SM
authors.lastname: Bateman
authors.forename: Debra
authors.initials: D
authors.lastname: O'Brien
authors.forename: Martyn A
authors.initials: MA
authors.lastname: French
authors.forename: O Patricia
authors.initials: OP
authors.lastname: Martinez
mesh_terms: D000328:Adult; D017714:Community-Acquired Infections / Q000209:etiology*; D004636:Emergency Service, Hospital; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D016602:Needlestick Injuries / Q000175:diagnosis* / Q000628:therapy*; D012189:Retrospective Studies; D014904:Western Australia; D055815:Young Adult